Q&A.pdf
PDF 103 KB Posted
- Attached to
- ITN NO. DMS-2425-258 COMPREHENSIVE SURGICAL AND MEDICAL BUNDLED SERVICES AND CANCER CARE COORDINATIO
- Solicitation number
- ITN-12526
- Issued by
- Leon County, Florida
About this file
This document is a Questions and Answers (Q&A) document for Invitation to Negotiate (ITN) No. DMS-24/25-258, issued by the State of Florida's Department of Management Services, Division of State Group Insurance, regarding Comprehensive Surgical and Medical Bundled Services and Cancer Care Coordination. The document addresses six key questions from potential bidders, covering topics such as the budgeted contract amount, current claim funding and payment processes, and eligibility requirements for bidders. Notably, the ITN does not require bidders to have a minimum number of covered lives, a minimum number of surgeries performed in Florida, or a minimum percentage of procedures completed within the state's boundaries.
The estimated annual contract amount is $4.4 million, which covers administration of bundled services and cancer care coordination for State of Florida employees and dependents enrolled in state plan health benefits. The current reimbursement process involves weekly invoicing with claims backup detail, which are reviewed and processed through a SPIA transfer from the Department of Financial Services, Florida Treasury to the vendor via ACH wire transfer. A critical requirement is that the selected entity must have a Third-Party Administrator (TPA) license to administer claims on behalf of the state, as referenced in Addendum 1. The claims for actual procedures are invoiced separately and reimbursed directly by the Division of State Group Insurance (DSGI), and these specific claims are not integrated with other medical claims paid by health TPA vendors.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment-A.Statment-of-Work.docx | DOCX document | |
| Attachment-F.PUR-7801-Vendor-Certification-Form.docx | DOCX document | |
| Attachment-B.Cost-Reply.xlsx | XLSX spreadsheet | |
| ITN-DMS-2425-258.Comprehensive-Med-Surgical-Bundled-Srvc-and-Cancer-Care-Coord.docx | DOCX document | |
| Addendum No.1.pdf | ||
| Attachment-E.Business-Associate-Agreement.docx | DOCX document | |
| attachment-D.technical-reply-with-weight.xlsx | XLSX spreadsheet | |
| Attachment-C.Contract-Draft.docx | DOCX document |
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Text version
ITN No. DMS-24/25-258
INVITATION TO NEGOTIATE NO. DMS-24/25-258
COMPREHENSIVE SURGICAL AND MEDICAL BUNDLED
SERVICES AND CANCER CARE COORDINATION
QUESTIONS AND ANSWERS
Note: All written questions are reproduced in the same format as submitted by the Respondent.
NO. QUESTION ANSWER
1.
ITN document- Section 1: Introduction
1.1 Solicitation Overview
Can you please help us understand what is included in the $4.4 M budgeted amount for this benefit?
Is this just associated with the fees of the program or is it the total for fees and dollars allocated to pay for the procedures performed?
a. The $4.4 million estimated annual contract amount is for the administration of the Bundled Services and Cancer Care Coordination to State of Florida employees and dependents enrolled in state plan health benefits.
b. This amount doesn’t include reimbursement of the procedures performed. The claims are invoiced separately to be reimbursed by the State of Florida, Division of State Group Insurance (DSGI).
2.
Attachment D, D-2 Technical Reply, 2.1.7
a. Can you please provide specifics on how your claim funding and payment is handled today?
b. We want to understand if you pay for bundled services directly to your current vendor or if you pay them through your current TPA partners?
c. If you pay for services directly to your current vendor, are those claim amounts being integrated back into all your medical claims being paid by your TPA partners?
a.&b. DSGI currently reimburses the current Bundled Services and Cancer Care Coordination vendor directly through daily banking processes. We receive a weekly invoice with claims backup detail for all completed procedures performed (cancer care coordination invoiced separately). The invoice and backup claim details are reviewed prior to processing a payment through a SPIA transfer from the Department of Financial Services, Florida Treasury to the vendor via an ACH wire transfer routed to the vendor’s specified banking institution on file with DFS Treasury.
c. No. These claims are not integrated back into all the other medical claims being paid by the other health TPA vendors.
ITN No. DMS-24/25-258
NO. QUESTION ANSWER
3.
Is there a minimum number of covered lives that you must currently have in the State of Florida (outside of the State’s business)?
No
4.
Does the bidder’s program need to have performed a minimum number of surgeries within the State’s boundaries within the prior year?
No
5.
Is there a minimum percentage of procedures that the bidder’s program must have capability of completing within the State’s boundaries?
No
6.
Does the entity selected need to have TPA license to administer claims on behalf of the State?
Yes. See Addendum 1.
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